“According to some sources, 60% of us will need long term care sometime during our lives. It is important for all of us to prepare for that day when we will need to help loved ones with elder care or we will need elder care for ourselves.”
“It is simply a fact of life to prepare financially for unexpected disasters by covering our homes, automobiles and health with insurance policies and to provide funding for our retirement. But no other life event can be as devastating to our lifestyle, finances and security as needing long term care. It drastically alters or completely eliminates the three principal retirement dreams of elderly Americans, which are:
1. Remaining independent in the home without intervention from others
2. Maintaining good health and receiving adequate health care
3. Having enough money for everyday needs and not outliving assets and income
Yet, it is our experience that the majority of the American public does not plan for the devastating crisis of needing elder care. This lack of planning also has an adverse effect on the older person's family, with sacrifices made in time, money, family lifestyles and even affecting the family's or caregiver's medical and emotional health.” National Care Planning Council “ The 4 Steps of Long Term Care Planning”
Because of changing demographics and potential changes in government funding, the current generation -- more-than-ever -- needs to plan for long term care.
If you have spent time helping a parent or loved one cope with a disability resulting from aging, you know the frustration of balancing what you feel they need to do and what they want to do. Communication is strained at times, because after all, you are the child and they the parent, yet physically and mentally the rolls have changed.
When you make directives, assignments and arrangements in advance of needing elder care, then everyone involved can follow the prearranged care plan.
As an example, Jefferson Simpson wrote in his care plan that if dementia or Alzheimer's inhibited his mental abilities to communicate or recognize his surroundings, he wished to be in a respectable facility and only asked that he be visited and brought chocolates. To his children this request seemed silly at the time, but when his mental capacities did diminish, the instructions were there. No one had to wonder if they should try to take care of Father Jefferson at home and how they would do it. Without quilt or question they placed him in a respectable facility that took care of his needs. All they had to do was make loving visits, and of course they brought chocolates.
In order for Jefferson's simple request to happen, he had made financial, legal and personal long term care plans years before.
What do you want your children or friends to do on your behalf?
When it comes time for them to help, what if you can't say what you want because of a physical or mental disability? This is where a written long term care plan comes into effect.
Do you have a financial plan or long term care insurance? Retirement savings can disappear quickly when used for care services.
Where is your paperwork; insurance policies, living will, medical directives, Armed Services discharge or disability papers? Is there someone designated to know the location?
What are the legal documents that are needed for power of attorney, estate planning and disbursement of assets? When do they have to be completed?
What types of care services and facilities are available and what are the costs?
What will government programs pay for and how do you qualify?
There is a lot you can do now to put together a plan for your own long term care. You may have limited resources in the future or health problems that will inhibit your ability to take care of things you could do now. For example.
James and Cindy want to be able to stay in their home as they age. In order to do this, when they were in their 40's they took out a long term care insurance policy that will pay for home care if it is needed. The policy will also pay for nursing home costs as a care option. With taking the policy at a younger age and in good health the monthly payments are low. Extra funds can now be put away for retirement without worries of having to deplete savings for care costs.
Or consider Sarah's following experience:
After taking care of her own parents for many years, Sarah realized the importance of making, in advance, a plan and preparations for herself. She saw all of her parents' assets dissipated in order for her father to qualify for Medicaid nursing home coverage. She didn't want the same thing to happen to her. She took the time to create her own plan on paper-- expressing her wishes for her own care. A trip to her attorney provided all the legal documents and estate planning she wanted to be in place to insure care for her and an inheritance for her children.
There is much to learn about long term care and there are a lot of new services and programs available to draw from.
The National Care Planning Council has gathered together an overall review of government and private long term care services both on the Council website, www.longtermcarelink.net and in their book The 4 Steps of Long Term Care Planning.
The 4 Steps of Long Term Care Planning provides comprehensive information about long term care planning. The design also allows you to record personal information, family agreements and directions on 20 planning sheets at the back of the book. Using this book as a single-source repository for information and directions makes it much easier for you or your care coordinator to carry out your wishes when the need for care occurs.
http://www.reversemortgageloan-rates.com/
Wednesday, October 14, 2009
Tuesday, October 13, 2009
Nursing Homes for Veterans
Nursing home coverage for veterans is available from two sources within the Department of Veterans Affairs -- the veterans health care system and the state veterans homes system.
Nursing Home Coverage through the VA Health Care System
Nursing home coverage along with other long term care services such as home care and assisted living as well as geriatric care management are available through the Veterans Health Administration for qualifying veterans.
In order to get into the veterans health care program, the veteran must have service-connected disabilities, or be below a qualifying income level or be receiving Veterans Pension income. Once in the system, veterans are not guaranteed long term care services, including nursing home care, unless they meet specific requirements. Here is a list of these requirements for nursing home coverage.
Who is Eligible for Nursing Home Care
•Any veteran who has a service-connected disability rating of 70 percent or more;
•A veteran who is rated 60 percent service-connected and is unemployable or has an official rating of "permanent and total disabled;"
•A veteran with combined disability ratings of 70 percent or more;
•A veteran whose service-connected disability is clinically determined to require nursing home care;
•Nonservice-connected veterans and those officially referred to as "zero percent, noncompensable, service-connected" veterans who require nursing home care for any nonservice-connected disability and who meet income and asset criteria; or
•If space and resources are available, other veterans on a case-by-case basis with priority given to service-connected veterans and those who need care for post-acute rehabilitation, respite, hospice, geriatric evaluation and management, or spinal cord injury.
VA's nursing home health system programs include VA-operated nursing home care units and contract community nursing homes. Many VA hospitals operate nursing home care units located in or near the hospital. Other hospitals, without adequate nursing home beds, contract with approximately 2,500 community private nursing homes nationwide to provide services.
State Veterans Homes
State veterans homes fill an important need for veterans with low income and veterans who desire to spend their last years with "comrades" from former active-duty. The predominant service offered is nursing home care. VA nursing homes must be licensed for their particular state and conform with skilled or intermediate nursing services offered in private sector nursing homes in that state. State homes may also offer assisted living or domiciliary care which is a form of supported independent living.
Every state has at least one veterans home and some states like Oklahoma have a number of them. There is great demand for the services of these homes, but lack of federal and state funding has created a backlog of well over 130 homes that are waiting to be built.
Unlike private sector nursing homes where the family can walk in the front door and possibly that same day make arrangements for a bed for their loved one, state veterans homes have an application process that could take a number of weeks or months. Many state homes have waiting lists especially for their Alzheimer's long term care units.
No facilities are entirely free to any veteran with an income. The veteran must pay his or her share of the cost. In some states the veterans contribution rates are set at a certain level and if there's not enough income the family may have to make up the difference. Federal legislation, effective 2007, also allows the federal government to substantially subsidize the cost of veterans with service-connected disabilities in state veterans homes.
State Veterans Homes Per Diem Program
The Veterans Administration pays the state veterans homes an annually adjusted rate per day for each veteran in the home. This is called the per diem. The 2008 nursing per diem amount is $74.42 and for domiciliary care it is $34.40. Adult Day Health Care – up to one-half of the cost of care -- cannot exceed $66.82 per day. The goal of state veterans homes is to get Congress to increase the per diem rate for nursing care to 75% of the state private nursing rates. In most states the per diem falls well short of this goal.
The per diem program and construction subsidies mean that State veterans homes can charge less money for their services than private facilities. Some states have a set rate, as an example $1,400 a month, and they may also be relying on qualified veterans receiving the Pension benefit with aid and attendance plus the per diem to cover their actual costs. Other states may charge a percentage of the veteran's income but be relying on other subsidies to cover the rest of the cost. Some state homes can receive Medicaid support as well.
Most of the states with income-determined rates are selective about the veterans they accept. These states may rely on a variety of private and public sources to help fund the cost of care.
Eligibility and Application Requirements for State Veterans Homes
From state to state, facilities vary in their rules for eligible veterans. And even in the same state it is common, where there is more than one state home, for some homes to have very stringent eligibility rules and others to be more lenient. These differing rules are probably based on the demand for care and the available beds in that particular geographic area.
Some homes require the veteran to be totally disabled and unable to earn an income. Some evaluate on the basis of medical need or age. Some evaluate entirely on income -- meaning applicants above a certain level will not be accepted. Some accept only former active-duty veterans, while others accept all who were in the military whether active duty or reserve. Still others accept only veterans who served during a period of war. Some homes accept the spouses or surviving spouses of veterans and some will accept the parents of veterans but restrict that to the parents of veterans who died while in service (Goldstar parents).
Federal regulations allow that 25% of the bed occupants at any one time may be veteran-related family members, i.e., spouses, surviving spouses, and/or gold star parents who are not entitled to payment of VA aid. When a State Home accepts grant assistance for a construction project, 75% of the bed occupants at the facility must be veterans.
Domicile residency requirements vary from state to state. The most stringent seems to be a three-year prior residency in the state whereas other homes may only require 90 days of residency.
All states require an application process to get into a home. Typically a committee or board will approve or disapprove each application. Many states have waiting lists for available beds.
A current contact list of all state veterans homes is available at http://www.longtermcarelink.net/ref_state_veterans_va_nursing_homes.htm
http://www.reversemortgageloans-rates.com/
Nursing Home Coverage through the VA Health Care System
Nursing home coverage along with other long term care services such as home care and assisted living as well as geriatric care management are available through the Veterans Health Administration for qualifying veterans.
In order to get into the veterans health care program, the veteran must have service-connected disabilities, or be below a qualifying income level or be receiving Veterans Pension income. Once in the system, veterans are not guaranteed long term care services, including nursing home care, unless they meet specific requirements. Here is a list of these requirements for nursing home coverage.
Who is Eligible for Nursing Home Care
•Any veteran who has a service-connected disability rating of 70 percent or more;
•A veteran who is rated 60 percent service-connected and is unemployable or has an official rating of "permanent and total disabled;"
•A veteran with combined disability ratings of 70 percent or more;
•A veteran whose service-connected disability is clinically determined to require nursing home care;
•Nonservice-connected veterans and those officially referred to as "zero percent, noncompensable, service-connected" veterans who require nursing home care for any nonservice-connected disability and who meet income and asset criteria; or
•If space and resources are available, other veterans on a case-by-case basis with priority given to service-connected veterans and those who need care for post-acute rehabilitation, respite, hospice, geriatric evaluation and management, or spinal cord injury.
VA's nursing home health system programs include VA-operated nursing home care units and contract community nursing homes. Many VA hospitals operate nursing home care units located in or near the hospital. Other hospitals, without adequate nursing home beds, contract with approximately 2,500 community private nursing homes nationwide to provide services.
State Veterans Homes
State veterans homes fill an important need for veterans with low income and veterans who desire to spend their last years with "comrades" from former active-duty. The predominant service offered is nursing home care. VA nursing homes must be licensed for their particular state and conform with skilled or intermediate nursing services offered in private sector nursing homes in that state. State homes may also offer assisted living or domiciliary care which is a form of supported independent living.
Every state has at least one veterans home and some states like Oklahoma have a number of them. There is great demand for the services of these homes, but lack of federal and state funding has created a backlog of well over 130 homes that are waiting to be built.
Unlike private sector nursing homes where the family can walk in the front door and possibly that same day make arrangements for a bed for their loved one, state veterans homes have an application process that could take a number of weeks or months. Many state homes have waiting lists especially for their Alzheimer's long term care units.
No facilities are entirely free to any veteran with an income. The veteran must pay his or her share of the cost. In some states the veterans contribution rates are set at a certain level and if there's not enough income the family may have to make up the difference. Federal legislation, effective 2007, also allows the federal government to substantially subsidize the cost of veterans with service-connected disabilities in state veterans homes.
State Veterans Homes Per Diem Program
The Veterans Administration pays the state veterans homes an annually adjusted rate per day for each veteran in the home. This is called the per diem. The 2008 nursing per diem amount is $74.42 and for domiciliary care it is $34.40. Adult Day Health Care – up to one-half of the cost of care -- cannot exceed $66.82 per day. The goal of state veterans homes is to get Congress to increase the per diem rate for nursing care to 75% of the state private nursing rates. In most states the per diem falls well short of this goal.
The per diem program and construction subsidies mean that State veterans homes can charge less money for their services than private facilities. Some states have a set rate, as an example $1,400 a month, and they may also be relying on qualified veterans receiving the Pension benefit with aid and attendance plus the per diem to cover their actual costs. Other states may charge a percentage of the veteran's income but be relying on other subsidies to cover the rest of the cost. Some state homes can receive Medicaid support as well.
Most of the states with income-determined rates are selective about the veterans they accept. These states may rely on a variety of private and public sources to help fund the cost of care.
Eligibility and Application Requirements for State Veterans Homes
From state to state, facilities vary in their rules for eligible veterans. And even in the same state it is common, where there is more than one state home, for some homes to have very stringent eligibility rules and others to be more lenient. These differing rules are probably based on the demand for care and the available beds in that particular geographic area.
Some homes require the veteran to be totally disabled and unable to earn an income. Some evaluate on the basis of medical need or age. Some evaluate entirely on income -- meaning applicants above a certain level will not be accepted. Some accept only former active-duty veterans, while others accept all who were in the military whether active duty or reserve. Still others accept only veterans who served during a period of war. Some homes accept the spouses or surviving spouses of veterans and some will accept the parents of veterans but restrict that to the parents of veterans who died while in service (Goldstar parents).
Federal regulations allow that 25% of the bed occupants at any one time may be veteran-related family members, i.e., spouses, surviving spouses, and/or gold star parents who are not entitled to payment of VA aid. When a State Home accepts grant assistance for a construction project, 75% of the bed occupants at the facility must be veterans.
Domicile residency requirements vary from state to state. The most stringent seems to be a three-year prior residency in the state whereas other homes may only require 90 days of residency.
All states require an application process to get into a home. Typically a committee or board will approve or disapprove each application. Many states have waiting lists for available beds.
A current contact list of all state veterans homes is available at http://www.longtermcarelink.net/ref_state_veterans_va_nursing_homes.htm
http://www.reversemortgageloans-rates.com/
Friday, October 9, 2009
Long Distance Care Givers Receive Help
Living in a different city or state -- miles from aging parents -- can be very difficult. Keeping in touch by telephone and making long trips to help parents or aging relatives with their needs can be time consuming and not nearly as effective as being available full time in person.
Mark Sessions spent two years juggling his restaurant business with multiple daily phone calls to his elderly parents, checking on their needs and answering their questions. Family vacations were spent traveling the 500 miles to his parent's home to personally take care of home maintenance and provide health care visits to their doctor. During his last visit, Mark noticed his father had difficulty walking and his mother was confused as to which medications she was to take and at what time. This alarming change in his parent's condition concerned Mark that his parents' care needs required more than frequent phone calls and vacation visits. Running his business and handling his parent's long distance care was now becoming very challenging.
According to a report by the Alzheimer's Association of Los Angeles & Riverside, California, there are approximately 3.3 million long distance caregivers in this country with an average distance of 480 miles from the people they care for. The report also states that 15 million days are missed from work each year because of long distance care giving. Seven million Americans provide 80% of the care to ailing family members and the number of long distance caregivers will DOUBLE over the next 15 years.
Long Distance Caregiver Project – Alzheimer's Association LA & Riverside, Los Angeles, CA (May 15, 2002, National Web Seminar by Judith Delaney, MFT, Clinical Coordinator)
The long distance caregiver is a new role that is thrust upon children and younger family members. Families used to live closer together, with children residing and working near their parents. But nowadays family members are more distant from each other. Society, today, is recognizing this. Some caregiver services have tweaked their programs to work as liaisons between long distance caregivers, senior loved ones and local medical professionals.
Professional care managers -- a lso known as Geriatric Care Managers, Elder Care Managers or Aging Care Managers -- represent a growing trend to help full time, employed family caregivers provide care for loved ones. Care managers are expert in assisting caregivers, friends or family members find government-paid and private resources to help with long term care decisions.
They are professionals -- trained to evaluate and recommend care for the aged. A care manager might be a nurse, social worker, psychologist, or gerontologist who specializes in assessing the abilities and needs of the elderly. Care manger professionals are also becoming extremely popular as the caretaker liaison between long distant family members and their aging elder loved ones.
Jacqueline Marcell -- author of "Elder Rage, or Take My Father...Please! How to Survive Caring for Aging Parents" (Impressive, 2000) -- says,
"The most important thing to do is to find a geriatric care manager in the area where your loved one lives. She will have knowledge of all the services in the area and can be your eyes."
Below is a partial list of what a care manager or Professional Geriatric Care Manager might do:
• Assess the level and type of care needed and develop a care plan.
• Take steps to start the care plan and keep it functioning.
• Make sure care is in a safe and disability friendly environment.
• Resolve family conflicts and other issues with long term care.
• Become an advocate for the care recipient and the caregiver.
• Manage care for a loved one for out-of-town families .
• Conduct ongoing assessments to implement changes in care.
• Oversee and direct care provided at home.
• Coordinate the efforts of key support systems.
• Provide personal counseling.
• Help with Medicaid qualification and application.
• Arrange for services of legal and financial advisors.
• Provide placement in assisted living facilities or nursing homes.
• Monitor the care received in a nursing home or in assisted living.
• Assist with the monitoring of medications.
• Find appropriate solutions to avoid a crisis.
• Coordinate medical appointments and medical information.
• Provide transportation to medical appointments
• Assist families in positive decision making
• Develop care plans for older loved ones not now needing care
“The 4 Steps of Long Term Care Planning,” National Care Planning Council
Services offered will depend on the educational and professional background of the care manager, but most are qualified to cover items in the list above or can recommend a professional who can. Fees may vary. There is often an initial consultation fee that is followed by hourly fees for services. Health insurance does not generally cover these fees but long-term care insurance might.
In 2002, the AARP published a survey from geriatric care mangers about their fees:
“Respondents were asked how much they charged for their services, which might include: an initial consultation; fees on an hourly or per visit basis; fees for development of a care plan; and fees on a fixed-price contract basis. Hourly fees averaged $74 an hour. GCMs charged an average $168 to develop a care plan. Initial consultations averaged $175. Seven of ten current GCMs responded in the affirmative when asked if they had a statement that listed their fees. ” Written by Robyn Stone, DrPH, Principal Investigator; Susan Reinhard, RN, PhD, Co-Principal Investigator; Jean Machemer, MSG, Research Associate; and Danylle Rudin, MSW, Research Associate of The Institute for the Future of Aging Services, Washington, D.C.Barbara Coleman, Project Manager, AARP Public Policy Institute November 2002
When you take into account the time absent from work and time to find the right care resources for your loved ones, along with the cost of travel expenses to monitor their care, you will probably concur that using a caregiver is money well spent. Add on to this the stress of handling your own life circumstances combined with being a caregiver and you will probably wonder how you could have ever done without the care manager.
A professional or geriatric care manager can be an important asset to all families in elder care situations. Here is an example of how a care manager can help.
Mary is taking care of her aging husband at home. He has diabetes and is overweight. Because of the diabetes, her husband has severe neuropathy in his legs and feet and it is difficult for him to walk. He also has diabetic retinopathy and, therefore, cannot see very well. She has to be careful that he does not injure his feet, since the last time that happened he was in the hospital for four weeks with a severe infection. She is having difficulty helping him out of bed and with dressing and using the bathroom. She relies heavily on her son, who lives nearby, to help her manage her husband's care.
On the advice of a friend, Mary is told about a professional care manager, Sharon Brown. The cost of an initial assessment and care plan from the care manager is $175.00. Mary thinks she has the situation under control and $175.00 for someone from the outside to come in and tell her how to deal with her situation seems ridiculous.
One day Mary is trying to lift her husband and injures her back severely. She is bedridden and cannot care for her husband. Her son, who works fulltime, now has two parents to care for. On the advice of the same friend, he decides to bring in Sharon Brown and pay her fee himself.
Sharon does a thorough assessment of the family's needs. She arranges for Mary's doctor to order Medicare home care during Mary's recovery. Therapists come in and help Mary with exercises and advice on lifting. Sharon advertises for and finds a private individual who is willing to live in the home for a period of time to help Mary with her recovery and watch over her husband. Sharon makes sure the new caregiver is reliable and honest and that taxes are paid for the employment. Sharon enlists the support of the local area agency on aging and makes sure all services available are provided for the family.
Sharon also calls a meeting with Mary's family and explains to them the care needs and how they need to commit to help with those needs. Sharon makes arrangements to rent or purchase medical equipment for lifting, moving and easier use of the bathroom facilities. Medicare will pay much of this cost. Sharon also works closely with an elder law attorney and a financial planner who specializes in the elderly. The attorney prepares documents for the family including powers of attorney, a living will and advice on preserving Mary's remaining assets. The financial planner recommends a reverse mortgage specialist to help Mary and her husband tap unused assets in their home's equity. Some reverse mortgage proceeds are used to pay off debt. The remaining proceeds are converted into income with a single premium immediate income annuity in order to provide Mary adequate income when her husband is gone and she looses one of the Social Security payments.
With the help of the care manager, Mary's life and future have been significantly improved. Her husband as well, if he adheres to the care plan, may end up having a better quality of life for his remaining years.
“The 4 Steps of Long Term Care Planning,” National Care Planning Council
The National Care Planning Council promotes and supports professional and geriatric care managers on its website www.longtermcarelink.net .
http://www.reversemortgageloans-rates.com/
Mark Sessions spent two years juggling his restaurant business with multiple daily phone calls to his elderly parents, checking on their needs and answering their questions. Family vacations were spent traveling the 500 miles to his parent's home to personally take care of home maintenance and provide health care visits to their doctor. During his last visit, Mark noticed his father had difficulty walking and his mother was confused as to which medications she was to take and at what time. This alarming change in his parent's condition concerned Mark that his parents' care needs required more than frequent phone calls and vacation visits. Running his business and handling his parent's long distance care was now becoming very challenging.
According to a report by the Alzheimer's Association of Los Angeles & Riverside, California, there are approximately 3.3 million long distance caregivers in this country with an average distance of 480 miles from the people they care for. The report also states that 15 million days are missed from work each year because of long distance care giving. Seven million Americans provide 80% of the care to ailing family members and the number of long distance caregivers will DOUBLE over the next 15 years.
Long Distance Caregiver Project – Alzheimer's Association LA & Riverside, Los Angeles, CA (May 15, 2002, National Web Seminar by Judith Delaney, MFT, Clinical Coordinator)
The long distance caregiver is a new role that is thrust upon children and younger family members. Families used to live closer together, with children residing and working near their parents. But nowadays family members are more distant from each other. Society, today, is recognizing this. Some caregiver services have tweaked their programs to work as liaisons between long distance caregivers, senior loved ones and local medical professionals.
Professional care managers -- a lso known as Geriatric Care Managers, Elder Care Managers or Aging Care Managers -- represent a growing trend to help full time, employed family caregivers provide care for loved ones. Care managers are expert in assisting caregivers, friends or family members find government-paid and private resources to help with long term care decisions.
They are professionals -- trained to evaluate and recommend care for the aged. A care manager might be a nurse, social worker, psychologist, or gerontologist who specializes in assessing the abilities and needs of the elderly. Care manger professionals are also becoming extremely popular as the caretaker liaison between long distant family members and their aging elder loved ones.
Jacqueline Marcell -- author of "Elder Rage, or Take My Father...Please! How to Survive Caring for Aging Parents" (Impressive, 2000) -- says,
"The most important thing to do is to find a geriatric care manager in the area where your loved one lives. She will have knowledge of all the services in the area and can be your eyes."
Below is a partial list of what a care manager or Professional Geriatric Care Manager might do:
• Assess the level and type of care needed and develop a care plan.
• Take steps to start the care plan and keep it functioning.
• Make sure care is in a safe and disability friendly environment.
• Resolve family conflicts and other issues with long term care.
• Become an advocate for the care recipient and the caregiver.
• Manage care for a loved one for out-of-town families .
• Conduct ongoing assessments to implement changes in care.
• Oversee and direct care provided at home.
• Coordinate the efforts of key support systems.
• Provide personal counseling.
• Help with Medicaid qualification and application.
• Arrange for services of legal and financial advisors.
• Provide placement in assisted living facilities or nursing homes.
• Monitor the care received in a nursing home or in assisted living.
• Assist with the monitoring of medications.
• Find appropriate solutions to avoid a crisis.
• Coordinate medical appointments and medical information.
• Provide transportation to medical appointments
• Assist families in positive decision making
• Develop care plans for older loved ones not now needing care
“The 4 Steps of Long Term Care Planning,” National Care Planning Council
Services offered will depend on the educational and professional background of the care manager, but most are qualified to cover items in the list above or can recommend a professional who can. Fees may vary. There is often an initial consultation fee that is followed by hourly fees for services. Health insurance does not generally cover these fees but long-term care insurance might.
In 2002, the AARP published a survey from geriatric care mangers about their fees:
“Respondents were asked how much they charged for their services, which might include: an initial consultation; fees on an hourly or per visit basis; fees for development of a care plan; and fees on a fixed-price contract basis. Hourly fees averaged $74 an hour. GCMs charged an average $168 to develop a care plan. Initial consultations averaged $175. Seven of ten current GCMs responded in the affirmative when asked if they had a statement that listed their fees. ” Written by Robyn Stone, DrPH, Principal Investigator; Susan Reinhard, RN, PhD, Co-Principal Investigator; Jean Machemer, MSG, Research Associate; and Danylle Rudin, MSW, Research Associate of The Institute for the Future of Aging Services, Washington, D.C.Barbara Coleman, Project Manager, AARP Public Policy Institute November 2002
When you take into account the time absent from work and time to find the right care resources for your loved ones, along with the cost of travel expenses to monitor their care, you will probably concur that using a caregiver is money well spent. Add on to this the stress of handling your own life circumstances combined with being a caregiver and you will probably wonder how you could have ever done without the care manager.
A professional or geriatric care manager can be an important asset to all families in elder care situations. Here is an example of how a care manager can help.
Mary is taking care of her aging husband at home. He has diabetes and is overweight. Because of the diabetes, her husband has severe neuropathy in his legs and feet and it is difficult for him to walk. He also has diabetic retinopathy and, therefore, cannot see very well. She has to be careful that he does not injure his feet, since the last time that happened he was in the hospital for four weeks with a severe infection. She is having difficulty helping him out of bed and with dressing and using the bathroom. She relies heavily on her son, who lives nearby, to help her manage her husband's care.
On the advice of a friend, Mary is told about a professional care manager, Sharon Brown. The cost of an initial assessment and care plan from the care manager is $175.00. Mary thinks she has the situation under control and $175.00 for someone from the outside to come in and tell her how to deal with her situation seems ridiculous.
One day Mary is trying to lift her husband and injures her back severely. She is bedridden and cannot care for her husband. Her son, who works fulltime, now has two parents to care for. On the advice of the same friend, he decides to bring in Sharon Brown and pay her fee himself.
Sharon does a thorough assessment of the family's needs. She arranges for Mary's doctor to order Medicare home care during Mary's recovery. Therapists come in and help Mary with exercises and advice on lifting. Sharon advertises for and finds a private individual who is willing to live in the home for a period of time to help Mary with her recovery and watch over her husband. Sharon makes sure the new caregiver is reliable and honest and that taxes are paid for the employment. Sharon enlists the support of the local area agency on aging and makes sure all services available are provided for the family.
Sharon also calls a meeting with Mary's family and explains to them the care needs and how they need to commit to help with those needs. Sharon makes arrangements to rent or purchase medical equipment for lifting, moving and easier use of the bathroom facilities. Medicare will pay much of this cost. Sharon also works closely with an elder law attorney and a financial planner who specializes in the elderly. The attorney prepares documents for the family including powers of attorney, a living will and advice on preserving Mary's remaining assets. The financial planner recommends a reverse mortgage specialist to help Mary and her husband tap unused assets in their home's equity. Some reverse mortgage proceeds are used to pay off debt. The remaining proceeds are converted into income with a single premium immediate income annuity in order to provide Mary adequate income when her husband is gone and she looses one of the Social Security payments.
With the help of the care manager, Mary's life and future have been significantly improved. Her husband as well, if he adheres to the care plan, may end up having a better quality of life for his remaining years.
“The 4 Steps of Long Term Care Planning,” National Care Planning Council
The National Care Planning Council promotes and supports professional and geriatric care managers on its website www.longtermcarelink.net .
http://www.reversemortgageloans-rates.com/
Thursday, October 8, 2009
Keeping Mom and Dad Safe at Home
Generally, elderly parents want to remain living in their own home. However, remaining in the home becomes a concern when children see their parents slowing down, perhaps even having trouble with handling stairs and doing general daily activities. Yet, with parents' mental and physical health currently not creating problems, there seems to be no imminent need to search out support services or other accommodations for aging parents.
This is now the time to evaluate the home to make it safe and secure for your loved ones -- now and in the near future -- in anticipation of aging disabilities that may occur. Help and support are available. The nation as a whole is more aware of elderly needs and services and products are becoming available at an outstanding pace.
The Bureau of Labor Statistics states,
“Employment of personal and home care aides is projected to grow by 51 percent between 2006 and 2016, which is much faster than the average for all occupations. The expected growth is due, in large part, to the projected rise in the number of elderly people, an age group that often has mounting health problems and that needs some assistance with daily activities.” Bureau of labor Statistics-Occupational Outlook Handbook, 2008-09 Edition
This growing need for aides and services also encompasses:
• home remodeling services -- making a home more serviceable to the elderly;
• safety alert systems and technology;
• motion sensors to monitor movement;
• telehealth services -- using home-based computer systems for the doctors office or a nurse to monitor vital signs and
• even a pill dispenser that notifies when it is time to take medication.
Where do you begin to make sure your elderly family member is safe and managing well in his or her home?
Visit often and at different times of the day and night. Make note of daily activities that appear challenging and where changes might be made to add safety and convenience. Remove rugs that slide -- causing a fall -- and move furniture with sharp edges. Set the water heater at a lower temperature. This will protect their older sensitive skin from scalds and burns. Be sure smoke detectors and carbon monoxide detectors are in place.
Bathrooms are a hazard area for the elderly. Grab bars by the toilet and shower are a must to help prevent falls. There are easy to install bars at your local hardware store if you want to do the work yourself. Another item that is good to have is a shower stool or chair.
If you are not sure of what needs to be done, consider hiring a professional. There are companies that specialize in home remodeling and accommodation for seniors. Michelle Graham of Accessible Design by Studio G4 says about senior home remodel projects,
“The main thing we incorporate in all of our projects is a careful study of needs and potential needs that may develop throughout a client's lifespan.”
Keep in mind what future home adjustments might be needed for your parents to “age in place” in their home.
Home safety or medical alert companies provide GPS-based bracelets or pendants to track the elderly at home who tend to wander. Or the companies may provide alarm devices such as pendants or bracelets which allow the elderly to alert someone if there has been a fall or a sudden health-related attack. In the event an alarm has been triggered, a 24 hour monitoring service will alert the family or medical emergency services or call a neighbor depending on previous instructions. In addition there are companies that will install motion sensors in the home to monitor the elderly on a 24 hour basis.
Don't forget your parents' community as a valuable resource for helping them stay in their home. Take Margaret Muller as an example. At 82 years of age, Margaret lives alone in her small home. She manages very well with the help of her local Senior Center. The Center's “Senior Companion” program sees that Margaret is taken to the store for groceries and other needs and checks in with her often to see how she is doing. Once a day, the Senior Center delivers a hot healthy meal to her door. Having these services and visits gives Margaret the help she needs and peace of mind that she is not alone.
Neighbors, local church groups, senior centers and city centers are some places to look for assistance. Most of the time there is little or no cost for these services.
Your state aging services unit is a valuable community resource. The National Area on Aging website www.aoa.gov states:
“AoA, through the Older Americans Act and other legislation, supports programs that help older adults maintain their independence and dignity in their homes and communities. In addition AoA provides funding for a range of supports to family caregivers.”
Some of the programs the site lists are:
Supportive Services and Senior Centers
Nutrition Services
National Family Caregiver Support Program
Grants for Native Americans
Nursing Home Diversion Grants
Aging & Disability Resource Centers
Evidence-Based Disease Prevention
Long-Term Care Planning
Alzheimer's Disease Grants
Naturally Occurring Retirement Communities
A few thoughts on hiring home care aides or live-in care givers.
The classifieds are filled with people looking for work as aides to the elderly. Many of these aides are well-qualified, honest people who will do a good job; but, of course, there will be some not so reputable. If you are looking to hire someone, be sure you interview and check references and qualifications. You will be responsible for scheduling that person and doing payroll and taxes as well. Be very sure you hire someone trustworthy, as the elderly seem to trust these helpers more than they should and therefore can easily be taken advantage of.
A professional home care service will eliminate your employment concerns. Professionally-provided aides are usually bonded and service is guaranteed. Home care companies take care of the scheduling and payment of their employees. Home care companies cater to the elderly in their homes by offering a variety of services. The National Care Planning Council lists many of these companies throughout the country on its website www.longtermcarelink.net .
These providers represent a rapidly growing trend to allow people needing help with long term care to remain in their home or in the community instead of going to a care facility. The services offered may include:
• companionship
• grooming and dressing
• recreational activities
• incontinent care
• handyman services
• teeth brushing
• medication reminders
• bathing or showering
• light housekeeping
• meal preparation
• respite for family caregivers
• errands and shopping
• reading email or letters
• overseeing home deliveries
• dealing with vendors
• transportation services
• changing linens
• laundry and ironing
• organizing closets
• care of house plants
• 24-hour emergency response
• family counseling
• phone call checks
• and much more.
Thomas Day, Director of the National Care Planning Council states,
“Care in the home provided by a spouse or a child is the most common form of long-term care in this country. About 73% of all long term care is provided in the home environment typically by family caregivers.”
As their caregiver, you can make the difference in the quality of life for your aging parents and if staying in their home is a possibility, you have the resources to make it happen.
http://www.reversemortgageloans-rates.com/
This is now the time to evaluate the home to make it safe and secure for your loved ones -- now and in the near future -- in anticipation of aging disabilities that may occur. Help and support are available. The nation as a whole is more aware of elderly needs and services and products are becoming available at an outstanding pace.
The Bureau of Labor Statistics states,
“Employment of personal and home care aides is projected to grow by 51 percent between 2006 and 2016, which is much faster than the average for all occupations. The expected growth is due, in large part, to the projected rise in the number of elderly people, an age group that often has mounting health problems and that needs some assistance with daily activities.” Bureau of labor Statistics-Occupational Outlook Handbook, 2008-09 Edition
This growing need for aides and services also encompasses:
• home remodeling services -- making a home more serviceable to the elderly;
• safety alert systems and technology;
• motion sensors to monitor movement;
• telehealth services -- using home-based computer systems for the doctors office or a nurse to monitor vital signs and
• even a pill dispenser that notifies when it is time to take medication.
Where do you begin to make sure your elderly family member is safe and managing well in his or her home?
Visit often and at different times of the day and night. Make note of daily activities that appear challenging and where changes might be made to add safety and convenience. Remove rugs that slide -- causing a fall -- and move furniture with sharp edges. Set the water heater at a lower temperature. This will protect their older sensitive skin from scalds and burns. Be sure smoke detectors and carbon monoxide detectors are in place.
Bathrooms are a hazard area for the elderly. Grab bars by the toilet and shower are a must to help prevent falls. There are easy to install bars at your local hardware store if you want to do the work yourself. Another item that is good to have is a shower stool or chair.
If you are not sure of what needs to be done, consider hiring a professional. There are companies that specialize in home remodeling and accommodation for seniors. Michelle Graham of Accessible Design by Studio G4 says about senior home remodel projects,
“The main thing we incorporate in all of our projects is a careful study of needs and potential needs that may develop throughout a client's lifespan.”
Keep in mind what future home adjustments might be needed for your parents to “age in place” in their home.
Home safety or medical alert companies provide GPS-based bracelets or pendants to track the elderly at home who tend to wander. Or the companies may provide alarm devices such as pendants or bracelets which allow the elderly to alert someone if there has been a fall or a sudden health-related attack. In the event an alarm has been triggered, a 24 hour monitoring service will alert the family or medical emergency services or call a neighbor depending on previous instructions. In addition there are companies that will install motion sensors in the home to monitor the elderly on a 24 hour basis.
Don't forget your parents' community as a valuable resource for helping them stay in their home. Take Margaret Muller as an example. At 82 years of age, Margaret lives alone in her small home. She manages very well with the help of her local Senior Center. The Center's “Senior Companion” program sees that Margaret is taken to the store for groceries and other needs and checks in with her often to see how she is doing. Once a day, the Senior Center delivers a hot healthy meal to her door. Having these services and visits gives Margaret the help she needs and peace of mind that she is not alone.
Neighbors, local church groups, senior centers and city centers are some places to look for assistance. Most of the time there is little or no cost for these services.
Your state aging services unit is a valuable community resource. The National Area on Aging website www.aoa.gov states:
“AoA, through the Older Americans Act and other legislation, supports programs that help older adults maintain their independence and dignity in their homes and communities. In addition AoA provides funding for a range of supports to family caregivers.”
Some of the programs the site lists are:
Supportive Services and Senior Centers
Nutrition Services
National Family Caregiver Support Program
Grants for Native Americans
Nursing Home Diversion Grants
Aging & Disability Resource Centers
Evidence-Based Disease Prevention
Long-Term Care Planning
Alzheimer's Disease Grants
Naturally Occurring Retirement Communities
A few thoughts on hiring home care aides or live-in care givers.
The classifieds are filled with people looking for work as aides to the elderly. Many of these aides are well-qualified, honest people who will do a good job; but, of course, there will be some not so reputable. If you are looking to hire someone, be sure you interview and check references and qualifications. You will be responsible for scheduling that person and doing payroll and taxes as well. Be very sure you hire someone trustworthy, as the elderly seem to trust these helpers more than they should and therefore can easily be taken advantage of.
A professional home care service will eliminate your employment concerns. Professionally-provided aides are usually bonded and service is guaranteed. Home care companies take care of the scheduling and payment of their employees. Home care companies cater to the elderly in their homes by offering a variety of services. The National Care Planning Council lists many of these companies throughout the country on its website www.longtermcarelink.net .
These providers represent a rapidly growing trend to allow people needing help with long term care to remain in their home or in the community instead of going to a care facility. The services offered may include:
• companionship
• grooming and dressing
• recreational activities
• incontinent care
• handyman services
• teeth brushing
• medication reminders
• bathing or showering
• light housekeeping
• meal preparation
• respite for family caregivers
• errands and shopping
• reading email or letters
• overseeing home deliveries
• dealing with vendors
• transportation services
• changing linens
• laundry and ironing
• organizing closets
• care of house plants
• 24-hour emergency response
• family counseling
• phone call checks
• and much more.
Thomas Day, Director of the National Care Planning Council states,
“Care in the home provided by a spouse or a child is the most common form of long-term care in this country. About 73% of all long term care is provided in the home environment typically by family caregivers.”
As their caregiver, you can make the difference in the quality of life for your aging parents and if staying in their home is a possibility, you have the resources to make it happen.
http://www.reversemortgageloans-rates.com/
Monday, October 5, 2009
The Hidden Secret of Elder Abuse
Many elderly people rely entirely on family or other trusted individuals to help them. Whether it is for physical needs or emotional needs, as people grow older they tend to need more and more help from others. This dependence on caregivers or family members makes an older person more vulnerable for abuse.
For example, an older person relying on her children to provide meals and transportation and help her with financial decisions finds it difficult to complain when one of her children takes advantage of her. If, for instance, the child takes her money, hits her or neglects her care, the parent may be threatened with loss of support from the child if the parent complains. The child may also use threats of violence to keep the parent in line.
It is estimated that 5% to 10% of elderly Americans are suffering abuse. According to the National Committee for the Prevention of Elder Abuse,
“Spiraling rates of elder mistreatment are reported by both practitioners and researchers. In a recent national study of Adult Protective Services (APS), typically the agency of first report concerning elder abuse, there were 253,421 reports of abuse of adults age 60+ or 832.6 reports for every 100,000 people over the age of 60 (Teaster, Dugar, Otto, Mendiondo, Abner, & Cecil, 2006). The National Elder Abuse Incidence Study (National Center on Elder Abuse, 1998) found that more than 500,000 persons aged 60+ were victims of domestic abuse and that an estimated 84% of incidents are not reported to authorities, denying victims the protection and support they need.”
Much attention has been focused on abuse in nursing homes but most of the elder abuse in this country is at the hands of family members or other caregivers in the home.
In 2004, Utah Adult Protective Services workers investigated approximately 2,400 allegations of abuse, neglect or exploitation of vulnerable adults. In Utah, a vulnerable adult is defined as an elder adult (65 years of age or older) or an adult (18 years of age or older) who has a mental or physical impairment, which substantially affects that person's ability to protect or provide for themselves. The majority of the victims were females between the ages of 60-89 and 60% of the perpetrators were family members/relatives, while 24% were non-related paid caregivers.
The protective needs identified were as follows:
• self-neglect 31%
• physical abuse 16%
• exploitation 19%
• caretaker neglect 12%
• emotional abuse 19%
• sexual abuse 3%
In conducting the investigations, it was not uncommon to find that adults who were self-neglecting were also being exploited or abused. As stated previously, these statistics are based on approximately 2,400 cases, thus, if only one in ten cases are ever reported, it is possible that there were actually 24,000 or more cases in Utah that year. We suspect 9 out of 10 is close to the actual ratio of unreported versus reported cases in Utah.
We also believe that Utah's lack of reporting elder abuse is not unlike other states in the country. We suspect all the states are experiencing close to the same ratios of underreporting as in Utah.
There are a number of reasons why incidents of abuse, neglect, or exploitation are not reported to Adult Protective Services or other authorities. One of the most common reasons is the victim's fear of losing support. Many of the perpetrators are family members and the victim fears that reporting the crime will result in removal of the caregiver, as the perpetrator may face incarceration or may discontinue relations with the victim once accused, charged, or convicted. Many of these victims fear that by reporting abuse they will be left alone and expected to care for themselves or they will be forced to live in a nursing home.
Many states have implemented mandatory reporting laws to assist in the prevention of abuse, neglect or exploitation of vulnerable adults. Utah is one of the many states to have a mandatory reporting law (U.C.A. § 76-5-111). Utah law states that any person who has reason to believe that a vulnerable adult has been the subject of abuse, neglect, or exploitation shall immediately notify Adult Protective Services or the nearest law enforcement agency. Anyone who makes the report in good faith is immune from civil liability in connection with the report; however, any person who willfully fails to report is guilty of a class B misdemeanor.
It is important to note that the anonymity of the person or persons making the initial report and any other persons involved in the subsequent investigation shall be preserved and may only be released in accordance with the rules of the division (U.C.A. § 62A-3-311). In addition, all investigation information is confidential.
The following is a list of indicators of abuse, neglect or exploitation. It is important to note that the following lists are merely indicators and may not always be violations.
Signs of Abuse:
• Unexplained bruises, welts, fractures, abrasions or lacerations
• Multiple bruises in various stages of healing
• Multiple/repeat injuries
• Low self-esteem or loss of self determination
• Withdrawn, passive
• Fearful
• Depressed, hopeless
• Soiled linen or clothing
• Social Isolation
Signs of Neglect/Self-Neglect:
• Dehydration
• Malnourishment
• Inappropriate or soiled clothing
• Odorous
• Over/under medicated
• Deserted, abandoned or unattended
• Lack of medical necessities or assistive devices
• Unclean environment
• Social Isolation
Signs of Exploitation:
• Missing/"disappearing" property
• Inadequate living environment
• Frequent/recent property title changes or will changes
• Excessive home repair bills
• Forced to sign over control of finances
• No/limited money for food, clothes and other amenities
Prevention can only occur if there is awareness, the statutes are adhered to, and any suspicions of abuse, neglect or exploitation of vulnerable adults are immediately reported to Adult Protective Services and/or law enforcement.
All states have agencies that receive complaints of abuse. In some states failure to report abuse of the elderly is a crime. To contact an abuse complaint department, call your local area agency on aging. To find an area agency on aging in your area go to http://www.longtermcarelink.net/eldercare/ref_state_aging_services.htm
http://www.reversemortgageloans-rates.com/
For example, an older person relying on her children to provide meals and transportation and help her with financial decisions finds it difficult to complain when one of her children takes advantage of her. If, for instance, the child takes her money, hits her or neglects her care, the parent may be threatened with loss of support from the child if the parent complains. The child may also use threats of violence to keep the parent in line.
It is estimated that 5% to 10% of elderly Americans are suffering abuse. According to the National Committee for the Prevention of Elder Abuse,
“Spiraling rates of elder mistreatment are reported by both practitioners and researchers. In a recent national study of Adult Protective Services (APS), typically the agency of first report concerning elder abuse, there were 253,421 reports of abuse of adults age 60+ or 832.6 reports for every 100,000 people over the age of 60 (Teaster, Dugar, Otto, Mendiondo, Abner, & Cecil, 2006). The National Elder Abuse Incidence Study (National Center on Elder Abuse, 1998) found that more than 500,000 persons aged 60+ were victims of domestic abuse and that an estimated 84% of incidents are not reported to authorities, denying victims the protection and support they need.”
Much attention has been focused on abuse in nursing homes but most of the elder abuse in this country is at the hands of family members or other caregivers in the home.
In 2004, Utah Adult Protective Services workers investigated approximately 2,400 allegations of abuse, neglect or exploitation of vulnerable adults. In Utah, a vulnerable adult is defined as an elder adult (65 years of age or older) or an adult (18 years of age or older) who has a mental or physical impairment, which substantially affects that person's ability to protect or provide for themselves. The majority of the victims were females between the ages of 60-89 and 60% of the perpetrators were family members/relatives, while 24% were non-related paid caregivers.
The protective needs identified were as follows:
• self-neglect 31%
• physical abuse 16%
• exploitation 19%
• caretaker neglect 12%
• emotional abuse 19%
• sexual abuse 3%
In conducting the investigations, it was not uncommon to find that adults who were self-neglecting were also being exploited or abused. As stated previously, these statistics are based on approximately 2,400 cases, thus, if only one in ten cases are ever reported, it is possible that there were actually 24,000 or more cases in Utah that year. We suspect 9 out of 10 is close to the actual ratio of unreported versus reported cases in Utah.
We also believe that Utah's lack of reporting elder abuse is not unlike other states in the country. We suspect all the states are experiencing close to the same ratios of underreporting as in Utah.
There are a number of reasons why incidents of abuse, neglect, or exploitation are not reported to Adult Protective Services or other authorities. One of the most common reasons is the victim's fear of losing support. Many of the perpetrators are family members and the victim fears that reporting the crime will result in removal of the caregiver, as the perpetrator may face incarceration or may discontinue relations with the victim once accused, charged, or convicted. Many of these victims fear that by reporting abuse they will be left alone and expected to care for themselves or they will be forced to live in a nursing home.
Many states have implemented mandatory reporting laws to assist in the prevention of abuse, neglect or exploitation of vulnerable adults. Utah is one of the many states to have a mandatory reporting law (U.C.A. § 76-5-111). Utah law states that any person who has reason to believe that a vulnerable adult has been the subject of abuse, neglect, or exploitation shall immediately notify Adult Protective Services or the nearest law enforcement agency. Anyone who makes the report in good faith is immune from civil liability in connection with the report; however, any person who willfully fails to report is guilty of a class B misdemeanor.
It is important to note that the anonymity of the person or persons making the initial report and any other persons involved in the subsequent investigation shall be preserved and may only be released in accordance with the rules of the division (U.C.A. § 62A-3-311). In addition, all investigation information is confidential.
The following is a list of indicators of abuse, neglect or exploitation. It is important to note that the following lists are merely indicators and may not always be violations.
Signs of Abuse:
• Unexplained bruises, welts, fractures, abrasions or lacerations
• Multiple bruises in various stages of healing
• Multiple/repeat injuries
• Low self-esteem or loss of self determination
• Withdrawn, passive
• Fearful
• Depressed, hopeless
• Soiled linen or clothing
• Social Isolation
Signs of Neglect/Self-Neglect:
• Dehydration
• Malnourishment
• Inappropriate or soiled clothing
• Odorous
• Over/under medicated
• Deserted, abandoned or unattended
• Lack of medical necessities or assistive devices
• Unclean environment
• Social Isolation
Signs of Exploitation:
• Missing/"disappearing" property
• Inadequate living environment
• Frequent/recent property title changes or will changes
• Excessive home repair bills
• Forced to sign over control of finances
• No/limited money for food, clothes and other amenities
Prevention can only occur if there is awareness, the statutes are adhered to, and any suspicions of abuse, neglect or exploitation of vulnerable adults are immediately reported to Adult Protective Services and/or law enforcement.
All states have agencies that receive complaints of abuse. In some states failure to report abuse of the elderly is a crime. To contact an abuse complaint department, call your local area agency on aging. To find an area agency on aging in your area go to http://www.longtermcarelink.net/eldercare/ref_state_aging_services.htm
http://www.reversemortgageloans-rates.com/
Friday, October 2, 2009
One Stop Shopping for Eldercare Services
A fast-growing generation of elderly people, needing care, is starting to put a great deal of pressure on caregiving family members. More and more we are seeing articles and books about the burden of long term care on families.
According to research By the National Care Planning Council, only about 16% of long-term care services are covered by the government. The other 84% are provided free of charge by family caregivers or provided by services paid out-of-pocket by families or from those receiving care. And the bulk of government care services are provided only after a care recipient has depleted all of his or her savings. The Council also estimates that at any given time approximately 22% of the population over age 65 is receiving some form of long term care support. About 44.4 million adult caregivers provide 21 hours a week of care with 4.3 years average time spent providing care. “National Care Planning Council”
Dilemma of Finding Eldercare Services
The need for care usually occurs without warning, when a stroke, heart failure or other medical condition or illness incident to age suddenly happens to an aging senior. Family members end up in panic mode trying to understand and educate themselves on what needs to be done and what resources are available. If they need to take time from work to handle the crisis then it becomes urgent to find answers and solve caregiving needs. The need to balance work with urgent caregiving responsibilities creates untold stress on employed family caregivers.
Most family caregivers simply don't know where to turn for help and advice.
Long term care services are complicated and provider contacts are fragmented throughout the community. For the majority of Americans, eldercare becomes a frustrating do-it-yourself process. How do you find out what government services are available and what they will pay for? What legal documents are necessary and how do you protect assets? What type of home care or facility care is needed? Should you quit your job to become the caregiver? Will the government or insurance pay you for caregiving to help replace your lost income?
The question often arises as to whether to use long term care professionals or go it alone in arranging care and services.
“Using care professionals is the most cost effective and efficient way to provide help for a loved one. Hiring professional advisers or providers to help with long term care is no different than using professionals to help with other complex issues such as car repairs, dealing with taxes, dealing with legal problems, or needing trained employees to help run a business. With their education and training, long term care professionals also bring experience that only comes from dealing with countless hands- on caregiving challenges”. “The 4 Steps of Long Term Care Planning”
One Central Source for Locating Help and Advice
The National Care Planning Council recognizes the need for family caregivers to educate themselves and find the needed resources and professional help quickly.
To fill the need for caregivers nationwide, the National Care Planning Council web site "Long Term Care Link", was developed as a comprehensive resource for long term care planning. There are hundreds of pages containing articles on long term care covering all aspects of caregiving and care services. Books are also available on how to plan for long term care and how to apply for your veterans benefits for long term care. NCPC books
If you are looking for government and community resources, there are lists with applicable website links. Some of those lists include National and State Area Agency on Aging Services, Senior Centers and Veterans Service Offices.
There are over 100 links to websites filled with reference materials. For example; the Gerontological Society of America, National Nursing Home Survey, Elder Law Answers, Senior Corps.
Find Eldercare Professional Service Providers in Your Area
The National Care Planning Council lists eldercare specialists and advisers who help families deal with the crisis and burden of long term care. These specialists can be found under the services category lists like the ones below, on the website. Each professional is listed under the State and area in the State that he or she services. A caregiver can go to the National Care Planning Council website and find someone in the area of need and read about the services of the listed company, individual or facility. Website visitors needing help can then call, email or fill in a request form to receive contact from a listed provider.
Listing categories on the website include the following specific services.
• Care Management, Guardianship, Conservatorship and Dispute Resolution
• Non-Medical Home Care
• Home Health Agency – Medicare-Covered Home Care and Hospice
• Home Maintenance, Deep Cleaning, Remodeling and Yard Work
• Veterans Benefits -- Consultant for the Aid and Attendance Pension Benefit
• Geriatric Health Care Practitioner or House Call Doctor
• Reverse Mortgage Specialist
• Elder Law Advice and Medicaid Advice
• Estate Planning, Tax Planning, Trust Management Services and End-Of-Life Planning
• Care Facility or New Home Search, Relocation, Downsizing and Real Estate Services
• Adult Day Care Services
• Insurance Products, Retirement Planning and Financial Advice
• Funeral & Burial Preplanning
THE NATIONAL CARE PLANNING COUNCIL INTRODUCES
ITS STATE CARE PLANNING COUNCIL WEBSITES
A state care planning council is an informal statewide alliance of eldercare specialists and advisers that helps families deal with the crisis and burden of long term care. When you go to your state care planning website, your search for help is right in your neighborhood.
Purpose of the State Care Planning Council
1. Educate the public on the need for care planning before a crisis occurs.
2. Provide, under one source, a list of providers representing most of the available
3. government and private services for eldercare.
4. Offer a trusted team of providers and advisers that the public will recognize in their area and can turn to for expert help in dealing with the challenges of long term care.
One Stop Shopping for Eldercare Services
State Care Planning Council websites offer a closer-to-home option for finding help and services to solve caregiving problems. Many of the local service providers work together as a team to help meet specific eldercare needs of the individual.
For example:
Tim and Debra, both in their late 80’s, were adamant about staying in their home. Both were taking medications and were mobile with walkers. Their daughter, Julie was concerned about their safety in the home, especially with avoiding hazardous falls, bathing and preparing meals. Tim insisted he could drive his car, even though he was a hazard on the road. Julie had taken the car keys and therefore faced an argument every time she went to their home.
Lately, Julie noticed that the required medications were not being taken. Tim was a diabetic and required monitoring with his insulin and diet. Julie ordered “Meals on Wheels” which her mother quickly canceled. Frustrated at having no cooperation from her parents, Julie realized she needed outside help.
Checking the internet for resources in her area, she found the name of a Professional Care Manager in her area listed on her State Care Planning Council website. Jackie -- the professional care manager and family dispute professional -- had worked many times with families like Julie and her parents.
A meeting was arranged where all parties to the caregiving were involved. Tim expressed that he did not want to give up his freedom driving to the store or other places he liked to go. Jackie suggested selling the car and using the money to pay a taxi or community transit. She arranged for Tim to see a geriatric physician to get his diet under control for his diabetes. Some in-home help with bathing, meal preparation and medication reminders was arranged by having a local non-medical home care company come in daily. Jackie gave Julie explicit instructions on how to organize the house to help prevent falls. To pay for the extra expense, Jackie introduced a reverse mortgage broker who explained how their home equity-- on a risk-free basis --could provide the money they needed for their care.
Every service provider or adviser Jackie brought in worked side-by-side with her on the state care planning council. Jackie knew they could provide the needed help with expertise and integrity.
Julie found that using professionals gave her peace of mind and confidence that her parents' care was in good hands.
The State Care Planning councils are just starting to grow and be populated with professional service providers throughout the Untied States. Like the National, the State websites are filled with resource material and articles for the public use.
Locate a State Care Planning Council at http://www.longtermcarelink.net/a15state_councils.htm
http://www.reversemortgageloans-rates.com/
According to research By the National Care Planning Council, only about 16% of long-term care services are covered by the government. The other 84% are provided free of charge by family caregivers or provided by services paid out-of-pocket by families or from those receiving care. And the bulk of government care services are provided only after a care recipient has depleted all of his or her savings. The Council also estimates that at any given time approximately 22% of the population over age 65 is receiving some form of long term care support. About 44.4 million adult caregivers provide 21 hours a week of care with 4.3 years average time spent providing care. “National Care Planning Council”
Dilemma of Finding Eldercare Services
The need for care usually occurs without warning, when a stroke, heart failure or other medical condition or illness incident to age suddenly happens to an aging senior. Family members end up in panic mode trying to understand and educate themselves on what needs to be done and what resources are available. If they need to take time from work to handle the crisis then it becomes urgent to find answers and solve caregiving needs. The need to balance work with urgent caregiving responsibilities creates untold stress on employed family caregivers.
Most family caregivers simply don't know where to turn for help and advice.
Long term care services are complicated and provider contacts are fragmented throughout the community. For the majority of Americans, eldercare becomes a frustrating do-it-yourself process. How do you find out what government services are available and what they will pay for? What legal documents are necessary and how do you protect assets? What type of home care or facility care is needed? Should you quit your job to become the caregiver? Will the government or insurance pay you for caregiving to help replace your lost income?
The question often arises as to whether to use long term care professionals or go it alone in arranging care and services.
“Using care professionals is the most cost effective and efficient way to provide help for a loved one. Hiring professional advisers or providers to help with long term care is no different than using professionals to help with other complex issues such as car repairs, dealing with taxes, dealing with legal problems, or needing trained employees to help run a business. With their education and training, long term care professionals also bring experience that only comes from dealing with countless hands- on caregiving challenges”. “The 4 Steps of Long Term Care Planning”
One Central Source for Locating Help and Advice
The National Care Planning Council recognizes the need for family caregivers to educate themselves and find the needed resources and professional help quickly.
To fill the need for caregivers nationwide, the National Care Planning Council web site "Long Term Care Link", was developed as a comprehensive resource for long term care planning. There are hundreds of pages containing articles on long term care covering all aspects of caregiving and care services. Books are also available on how to plan for long term care and how to apply for your veterans benefits for long term care. NCPC books
If you are looking for government and community resources, there are lists with applicable website links. Some of those lists include National and State Area Agency on Aging Services, Senior Centers and Veterans Service Offices.
There are over 100 links to websites filled with reference materials. For example; the Gerontological Society of America, National Nursing Home Survey, Elder Law Answers, Senior Corps.
Find Eldercare Professional Service Providers in Your Area
The National Care Planning Council lists eldercare specialists and advisers who help families deal with the crisis and burden of long term care. These specialists can be found under the services category lists like the ones below, on the website. Each professional is listed under the State and area in the State that he or she services. A caregiver can go to the National Care Planning Council website and find someone in the area of need and read about the services of the listed company, individual or facility. Website visitors needing help can then call, email or fill in a request form to receive contact from a listed provider.
Listing categories on the website include the following specific services.
• Care Management, Guardianship, Conservatorship and Dispute Resolution
• Non-Medical Home Care
• Home Health Agency – Medicare-Covered Home Care and Hospice
• Home Maintenance, Deep Cleaning, Remodeling and Yard Work
• Veterans Benefits -- Consultant for the Aid and Attendance Pension Benefit
• Geriatric Health Care Practitioner or House Call Doctor
• Reverse Mortgage Specialist
• Elder Law Advice and Medicaid Advice
• Estate Planning, Tax Planning, Trust Management Services and End-Of-Life Planning
• Care Facility or New Home Search, Relocation, Downsizing and Real Estate Services
• Adult Day Care Services
• Insurance Products, Retirement Planning and Financial Advice
• Funeral & Burial Preplanning
THE NATIONAL CARE PLANNING COUNCIL INTRODUCES
ITS STATE CARE PLANNING COUNCIL WEBSITES
A state care planning council is an informal statewide alliance of eldercare specialists and advisers that helps families deal with the crisis and burden of long term care. When you go to your state care planning website, your search for help is right in your neighborhood.
Purpose of the State Care Planning Council
1. Educate the public on the need for care planning before a crisis occurs.
2. Provide, under one source, a list of providers representing most of the available
3. government and private services for eldercare.
4. Offer a trusted team of providers and advisers that the public will recognize in their area and can turn to for expert help in dealing with the challenges of long term care.
One Stop Shopping for Eldercare Services
State Care Planning Council websites offer a closer-to-home option for finding help and services to solve caregiving problems. Many of the local service providers work together as a team to help meet specific eldercare needs of the individual.
For example:
Tim and Debra, both in their late 80’s, were adamant about staying in their home. Both were taking medications and were mobile with walkers. Their daughter, Julie was concerned about their safety in the home, especially with avoiding hazardous falls, bathing and preparing meals. Tim insisted he could drive his car, even though he was a hazard on the road. Julie had taken the car keys and therefore faced an argument every time she went to their home.
Lately, Julie noticed that the required medications were not being taken. Tim was a diabetic and required monitoring with his insulin and diet. Julie ordered “Meals on Wheels” which her mother quickly canceled. Frustrated at having no cooperation from her parents, Julie realized she needed outside help.
Checking the internet for resources in her area, she found the name of a Professional Care Manager in her area listed on her State Care Planning Council website. Jackie -- the professional care manager and family dispute professional -- had worked many times with families like Julie and her parents.
A meeting was arranged where all parties to the caregiving were involved. Tim expressed that he did not want to give up his freedom driving to the store or other places he liked to go. Jackie suggested selling the car and using the money to pay a taxi or community transit. She arranged for Tim to see a geriatric physician to get his diet under control for his diabetes. Some in-home help with bathing, meal preparation and medication reminders was arranged by having a local non-medical home care company come in daily. Jackie gave Julie explicit instructions on how to organize the house to help prevent falls. To pay for the extra expense, Jackie introduced a reverse mortgage broker who explained how their home equity-- on a risk-free basis --could provide the money they needed for their care.
Every service provider or adviser Jackie brought in worked side-by-side with her on the state care planning council. Jackie knew they could provide the needed help with expertise and integrity.
Julie found that using professionals gave her peace of mind and confidence that her parents' care was in good hands.
The State Care Planning councils are just starting to grow and be populated with professional service providers throughout the Untied States. Like the National, the State websites are filled with resource material and articles for the public use.
Locate a State Care Planning Council at http://www.longtermcarelink.net/a15state_councils.htm
http://www.reversemortgageloans-rates.com/
Thursday, October 1, 2009
Medication Problems and the Elderly
At 83 years old, Martha still lived in her own home, and enjoyed working in her garden and canning peaches. It was becoming harder to motivate herself, to get up in the mornings and accomplish the day's tasks. She confided to her daughter that she felt anxious and tired. Her daughter, who was taking medication for her anxiety, took Martha to her own doctor, not Martha's and got her a prescription for Valium. In doing so, the daughter's doctor, who had never seen Martha and who did not have her medical history, was only aware of a few medications they told him she was taking.
Martha, in fact, was taking 9 different medications as well as herbal supplements.
The addition of Valium to her existing list of prescribed drugs sent her to the emergency room with respiratory distress. If she had gone to her own doctor, he would have found that a dosage adjustment of her current medications would have solved her anxiety.
Medication errors are common in the elderly. Many seniors take on average 6- 8 different prescriptions as well as over the counter drugs. Many times the elderly will not go back to their doctor to have their dosage evaluated and changed if necessary. Family members should be aware, that elderly parents may tend to take the family's advice over going to their own doctor. Even though children want to help increase the health and stamina of their parents, they may in fact be causing damage by misdirecting their loved ones.
Where a younger person can benefit from herbal supplements like Ginkgo Biloba, Saw Palmetto and others, in older people, these herbals may cause adverse reactions with their prescription medications.
In 2003, a panel of experts put together a list of potential medications that would not be appropriate to give to seniors. This is called the “ Beers List ” after one of the research professionals.
Dr. Donna M Fick, R.N. one of the panel members for updating the “Beers List,” states in her article on Seniorjournal.com:
"Just as our bodies physically slow down as we age, changes occur in the way that older bodies handle pharmaceuticals, and this has motivated experts to develop a list of drugs that may be harmful to elderly patients.
"With age, drugs tend to build up in the body, and the distribution and elimination of drugs from the body changes as well," says Dr. Donna M. Fick, R.N., associate professor of nursing at Penn State. "Many drugs, like diazepam (Valium) and other anti-anxiety drugs build up fast."
An on-line article on HealthSquare.com , Titled "Drugs and the Elderly," talks about physical symptoms and medications.
“ Among the first signs that a drug may not be working properly in an older person is a change in mood, energy, attitude, or memory. Too often, these alterations are overlooked, ignored, or chalked off to "old age" or senility. Older people may themselves feel that their blue mood is caused by something external such as the death of a friend or simply by boredom. Nothing could be farther from the truth. Virtually every heart medication, blood pressure drug, sleeping pill, and tranquilizer has been known to trigger depressive symptoms.
When a psychological symptom appears in an older person, examine his or her medication or drug use first. Consider, too, factors like alcohol intake, poor nutrition, and hormone imbalance. And never dismiss the possibility that a real psychological problem has developed and may itself require medication.”
There are many things family members can do to help monitor medications for their elderly parents.
• Make a list of medicines prescribed and all supplements being taken.
• Give this list to the doctor and pharmacist and have one on hand for emergencies.
• Use the same Pharmacy to fill all prescriptions. Pharmacies keep a record of your prescribed drugs and will verify your doctor's instructions. They will also tell you if foods or over the counter supplements will interact with a prescription.
• Dispense pills in a daily pill organizer box.
• Have a family member be responsible to call or physically monitor the taking of medication
Family members who live long distances from their elders have available to them
new technology in medication monitoring.
• Alarms for pill boxes, watch alarms, medical alarm bands and necklaces that ring a reminder.
• Computerized pill box dispensers that ring a designated number if the pills have not been taken.
• Home Telehealth -
“Technology has developed computer and computer cameras to help the elderly in their homes stay safe and healthy. Home telehealth-set up by medical professionals in the home--enables providers to monitor such things as medications and blood pressure and actually see the patient. Patient questions are answered and advice is given, while the monitoring nurse views through the video phone how his or her patient looks physically.” The 4 Steps of Long Term Care Planning, Pg 92
• Home Care Agencies – Home care companies offer a variety of service options in helping families care for and properly dispense medication to their elder parents.
Find a home care agency in your area http://www.longtermcarelink.net/a7homecare.htm
Overmedication or taking medication incorrectly may lead to early mental confusion and decline in health in seniors. “If medication problems were ranked as a disease in cause of death it would be the 5 th leading cause in the United States”. (from article on LongTermLiving)
http://www.reversemortgageloans-rates.com/
Martha, in fact, was taking 9 different medications as well as herbal supplements.
The addition of Valium to her existing list of prescribed drugs sent her to the emergency room with respiratory distress. If she had gone to her own doctor, he would have found that a dosage adjustment of her current medications would have solved her anxiety.
Medication errors are common in the elderly. Many seniors take on average 6- 8 different prescriptions as well as over the counter drugs. Many times the elderly will not go back to their doctor to have their dosage evaluated and changed if necessary. Family members should be aware, that elderly parents may tend to take the family's advice over going to their own doctor. Even though children want to help increase the health and stamina of their parents, they may in fact be causing damage by misdirecting their loved ones.
Where a younger person can benefit from herbal supplements like Ginkgo Biloba, Saw Palmetto and others, in older people, these herbals may cause adverse reactions with their prescription medications.
In 2003, a panel of experts put together a list of potential medications that would not be appropriate to give to seniors. This is called the “ Beers List ” after one of the research professionals.
Dr. Donna M Fick, R.N. one of the panel members for updating the “Beers List,” states in her article on Seniorjournal.com:
"Just as our bodies physically slow down as we age, changes occur in the way that older bodies handle pharmaceuticals, and this has motivated experts to develop a list of drugs that may be harmful to elderly patients.
"With age, drugs tend to build up in the body, and the distribution and elimination of drugs from the body changes as well," says Dr. Donna M. Fick, R.N., associate professor of nursing at Penn State. "Many drugs, like diazepam (Valium) and other anti-anxiety drugs build up fast."
An on-line article on HealthSquare.com , Titled "Drugs and the Elderly," talks about physical symptoms and medications.
“ Among the first signs that a drug may not be working properly in an older person is a change in mood, energy, attitude, or memory. Too often, these alterations are overlooked, ignored, or chalked off to "old age" or senility. Older people may themselves feel that their blue mood is caused by something external such as the death of a friend or simply by boredom. Nothing could be farther from the truth. Virtually every heart medication, blood pressure drug, sleeping pill, and tranquilizer has been known to trigger depressive symptoms.
When a psychological symptom appears in an older person, examine his or her medication or drug use first. Consider, too, factors like alcohol intake, poor nutrition, and hormone imbalance. And never dismiss the possibility that a real psychological problem has developed and may itself require medication.”
There are many things family members can do to help monitor medications for their elderly parents.
• Make a list of medicines prescribed and all supplements being taken.
• Give this list to the doctor and pharmacist and have one on hand for emergencies.
• Use the same Pharmacy to fill all prescriptions. Pharmacies keep a record of your prescribed drugs and will verify your doctor's instructions. They will also tell you if foods or over the counter supplements will interact with a prescription.
• Dispense pills in a daily pill organizer box.
• Have a family member be responsible to call or physically monitor the taking of medication
Family members who live long distances from their elders have available to them
new technology in medication monitoring.
• Alarms for pill boxes, watch alarms, medical alarm bands and necklaces that ring a reminder.
• Computerized pill box dispensers that ring a designated number if the pills have not been taken.
• Home Telehealth -
“Technology has developed computer and computer cameras to help the elderly in their homes stay safe and healthy. Home telehealth-set up by medical professionals in the home--enables providers to monitor such things as medications and blood pressure and actually see the patient. Patient questions are answered and advice is given, while the monitoring nurse views through the video phone how his or her patient looks physically.” The 4 Steps of Long Term Care Planning, Pg 92
• Home Care Agencies – Home care companies offer a variety of service options in helping families care for and properly dispense medication to their elder parents.
Find a home care agency in your area http://www.longtermcarelink.net/a7homecare.htm
Overmedication or taking medication incorrectly may lead to early mental confusion and decline in health in seniors. “If medication problems were ranked as a disease in cause of death it would be the 5 th leading cause in the United States”. (from article on LongTermLiving)
http://www.reversemortgageloans-rates.com/
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